Detection of Cytomegalovirus in Patients with Inflammatory Bowel Disease

McCurdy, Jeffrey D.; Enders, Felicity; Jones, Andrea; Killian, Jill M.; Loftus, Edward V.; Smyrk, Thomas C.

doi:10.1097/mib.0000000000000556

Cited by 95 publications

(45 citation statements)

References 34 publications

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“…An additional strength of our study is that we were able to compare the different methods generally used to assess the presence of CMV on colonic tissue biopsies, thus confirming the high sensitivity of PCR CMV and the low sensitivity of whole blood PCR CMV in concordance with data published by others [13,16]. …”

Section: Discussionsupporting

confidence: 69%

“…We performed a minimum of 3 biopsies from inflamed colonic mucosa. This number is significantly lower than recently published by McCurdy et al [13]. However, the histopathological and IHC detection rate in our cohort is relatively high (IHC 32%, histopathology 21%) and is backed up by tissue CMV PCR.…”

Section: Discussioncontrasting

confidence: 49%

“…Viral DNA load in tissues (genome copies/mg) or whole blood samples (genome copies/mL) was determined by quantitative real-time PCR assay as previously described, with the use of primers and probes derived from the CMV glycoprotein B and immediate early genes. The assay demonstrated a linear quantitation over a 6-log range with a sensitivity of 50 copies/mL [12,13]. …”

Section: Methodsmentioning

confidence: 99%

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Diagnosis of Cytomegalovirus Infection during Exacerbation of Ulcerative Colitis

Levin

Yaari²,

Stoff³

et al. 2017

Digestion

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Background/Aims: The role of cytomegalovirus (CMV) reactivation during exacerbations of ulcerative colitis (UC) is yet a matter of debate, and assessment of CMV infection in UC patients remains an ongoing challenge. We aimed to identify associated parameters and compare detection methods for CMV infection during UC exacerbation. Methods: Clinical, pathological and virological parameters were retrospectively analyzed in all patients hospitalized in our institution for UC exacerbation between January 2009 and April 2015, who underwent full evaluation for CMV infection in colonic tissue by histopathology, immunohistochemistry (IHC) and CMV-PCR. Results: Of 28 patients who underwent full examination for tissue CMV-infection, 13 (46.4%) were found to be positive for CMV. Tissue CMV-PCR was more sensitive for the detection of CMV infection than histopathology and IHC. CMV-positive patients had a statistically higher frequency of recent steroid treatment and fever, with higher mean partial Mayo scores and lower mean albumin levels. There were no significant differences between CMV-positive and CMV-negative patients in terms of age, severity of colitis and disease duration. In a multivariable model, only recent steroid treatment and fever were independently associated with colonic CMV infection. Conclusions: This study provides a clinical model to detect the presence of CMV infection in patients hospitalized with UC exacerbation, which could direct proper investigation and facilitate timely empirical therapy

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Section: Discussionsupporting

confidence: 69%

Section: Discussioncontrasting

confidence: 49%

Section: Methodsmentioning

confidence: 99%

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Diagnosis of Cytomegalovirus Infection during Exacerbation of Ulcerative Colitis

Levin

Yaari²,

Stoff³

et al. 2017

Digestion

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“…The significance of this difference is not well understood. Very recently, McCurdy et al [60] reported that 11 biopsies in UC were required to achieve an 80% probability of a positive biopsy. However, one can question the clinical significance of CMV infection of the colon, if such a number of biopsies are necessary to prove it.…”

Section: Antigenimia Assay Endoscopy Histology or Cmv-dna Pcr: Whimentioning

confidence: 99%

Cytomegalovirus Colitis, Cytomegalovirus Hepatitis and Systemic Cytomegalovirus Infection: Common Features and Differences

Nakase

Herfarth

2016

Inflamm Intest Dis

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Cytomegalovirus (CMV) is a ubiquitous human herpes virus, which, after often asymptomatic primary infection, establishes a lifelong latent infection that can periodically be reactivated in both immunocompetent and immunosuppressed carriers. Whereas the diagnostic approach in case of a suspicion of CMV reactivation is well defined, the indication for antiviral therapy can often only be made in the context of an extent of organ involvement, the immune status, and comorbidities of the patient. This article reviews the epidemiology, diagnosis, and therapy of CMV reactivation with a focus on inflammatory bowel diseases and potentially different diagnostic and therapeutic approaches in Asia and the Western world.

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“…Roblin et al ( 2 ) and others ( 1,(11)(12)(13)(14) documented that the measure of CMV DNA load was more sensitive than immunohistochemistry (IHC) for CMV detection in IBD. In a recent paper, McCurdy et al ( 15 ) suggested the need to examine a large number of biopsies by IHC in order to achieve adequate sensitivity. Th e use of qPCR presents the advantage of reducing the number of biopsies to be examined; in addition, the result can be obtained in only 48 h. Th e cost of qPCR was estimated to ~15 euros per test, which results in a total cost of 30 euros per fl are-up when two biopsies are examined.…”

mentioning

confidence: 98%

Distribution of Cytomegalovirus DNA Load in the Inflamed Colon of Ulcerative Colitis Patients

Pillet

Williet

Pouvaret

et al. 2016

American Journal of Gastroenterology

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Detection of Cytomegalovirus in Patients with Inflammatory Bowel Disease

Abstract: Biopsy location and number are important considerations when assessing for CMV. We recommend a flexible sigmoidoscopy with 11 biopsies in UC and a colonoscopy with 16 biopsies in CD.

Cited by 95 publications

References 34 publications

Diagnosis of Cytomegalovirus Infection during Exacerbation of Ulcerative Colitis

Diagnosis of Cytomegalovirus Infection during Exacerbation of Ulcerative Colitis

Cytomegalovirus Colitis, Cytomegalovirus Hepatitis and Systemic Cytomegalovirus Infection: Common Features and Differences

Distribution of Cytomegalovirus DNA Load in the Inflamed Colon of Ulcerative Colitis Patients

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